Risk of SARS-CoV-2 following joint and epidural corticosteroid injections: A retrospective study.

IF 2.5 3区医学 Q2 ANESTHESIOLOGY

Pain Practice Pub Date : 2024-03-01 Epub Date: 2023-11-23 DOI:10.1111/papr.13321

Robin Raju, Eric K Holder, Mark Dundas, Jingchen Liang, Rebecca Donham

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引用次数: 0

Abstract

Objective: The immunosuppressive effects of corticosteroid (CS) injections have come under more scrutiny during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to explore any relationship between joint/epidural CS injection and SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) polymerase chain reaction (PCR) positivity.

Methods: A retrospective chart review was conducted on patients 18 years or over who received at least one joint or epidural CS injection by physiatrists in a tertiary care center between January 1, 2020, and December 31, 2021. This cohort of patients was then compared to a control group who did not receive any CS injection during this time period.

Results: A total of 766 patients were identified in the CS injection group and 1546 patients in the control group. Overall, 12.27% of patients turned SARS-CoV-2 PCR positive in the CS injection group, which was similar to 11.90% in the control group (p = 0.797). But 3-month SARS-CoV-2 PCR positivity rate showed a statistically significant higher rate among the CS injection group (3.30% in the CS injection group vs. 2.10% in the control group; p = 0.027). In multivariate regression analysis, after adjusting both groups for Charlson Comorbidity Index (CCI), there was statistically significant higher SARS-CoV-2 PCR positivity rate in the CS injection group (p = 0.024). However, after adjusting both groups for age and total number of comorbidities, there was no difference between the groups in regard to SARS-CoV-2 PCR positivity rate (p = 0.081). In the subgroup analysis of only COVID-19 vaccinated patients, there was an increased 3-month SARS-CoV-2 PCR positivity rate among patients with severe comorbidities in the CS injection group (p = 0.036).

Conclusion: The study was not conclusive on the effect of joint or epidural CS injection on SARS-CoV-2 PCR positivity rate, although adjusted analysis suggests higher 3-month SARS-CoV-2 PCR positivity rate after CS injection in patients with severe comorbidities with significant disease burden when compared to controls.

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关节和硬膜外皮质类固醇注射后发生SARS-CoV-2的风险:一项回顾性研究

目的:在2019冠状病毒病(COVID-19)大流行期间，皮质类固醇(CS)注射的免疫抑制作用受到了更多的关注。本研究的目的是探讨关节/硬膜外注射CS与SARS-CoV-2(严重急性呼吸综合征冠状病毒2)聚合酶链反应(PCR)阳性的关系。方法:对2020年1月1日至2021年12月31日期间在三级保健中心接受至少一次关节或硬膜外CS注射的18岁或以上的患者进行回顾性图表回顾。然后将该队列患者与在此期间未接受任何CS注射的对照组进行比较。结果:CS注射组共766例，对照组共1546例。总体而言，CS注射组有12.27%的患者转为SARS-CoV-2 PCR阳性，与对照组的11.90%相似(p = 0.797)。但3个月SARS-CoV-2 PCR阳性率在CS注射组中较高(CS注射组为3.30%，对照组为2.10%;p = 0.027)。多因素回归分析显示，调整两组Charlson共病指数(CCI)后，CS注射组SARS-CoV-2 PCR阳性率显著高于对照组(p = 0.024)。然而，在调整两组患者的年龄和共病总数后，两组之间的SARS-CoV-2 PCR阳性率无差异(p = 0.081)。在仅接种COVID-19疫苗的患者亚组分析中，CS注射组有严重合并症的患者3个月SARS-CoV-2 PCR阳性率升高(p = 0.036)。结论:本研究未得出联合或硬膜外注射CS对SARS-CoV-2 PCR阳性率的影响，但校正分析显示，与对照组相比，有严重合合症且疾病负担显著的患者注射CS后3个月SARS-CoV-2 PCR阳性率较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain Practice ANESTHESIOLOGY-CLINICAL NEUROLOGY

CiteScore

5.60

自引率

3.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Pain Practice, the official journal of the World Institute of Pain, publishes international multidisciplinary articles on pain and analgesia that provide its readership with up-to-date research, evaluation methods, and techniques for pain management. Special sections including the Consultant’s Corner, Images in Pain Practice, Case Studies from Mayo, Tutorials, and the Evidence-Based Medicine combine to give pain researchers, pain clinicians and pain fellows in training a systematic approach to continuing education in pain medicine. Prior to publication, all articles and reviews undergo peer review by at least two experts in the field.